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General NPI Number Information
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NPI Number | 1336365592
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Entity Type | Individual
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Provider Name | TIMOTHY PATRICK CARNEY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4780 INDUSTRIAL DR
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City | MILLINGTON
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State | MI
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Zip | 48746-9342
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Country | US
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Telephone | 989-871-4576
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Fax | 989-871-4585
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Provider Business Mailing Address
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Address Line | 1675 GRAY RD
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City | LAPEER
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State | MI
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Zip | 48446-7795
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Country | US
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Telephone | 810-664-5062
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Fax | 989-871-4585
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901016238
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License Number State | MI
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